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Also known simply as a "physical," a physical examination is the process by which a physician inspects various organ systems and other parts of the patient's body. It provides the physician the opportunity to look for signs of heart disease or other illnesses. Aside from taking a full medical history, this process is the most important strategy in identifying cardiovascular conditions and other illnesses.
The physician uses a fairly structured process to conduct the exam. In general, a physical includes these four elements:
- Inspection. After collecting information through a medical history, the physician will look at various parts of the patient's body, with a focus on any region of complaint.
- Palpation. Gently pressing the skin can help the physician identify areas of tenderness or swelling, as well as the size and texture of a growth, organ or other body part. During a cardiac exam, the chest may be palpated to feel for any abnormalities.
- Percussion. Most people have had their chest gently tapped by a physician's fingers. This is an example of percussion, tapping on the chest or abdomen to gauge normal or abnormal responses. Different areas of the body elicit different responses, depending on the structures and tissues present. For instance, if you tap on your chest bone, or sternum, the area should sound relatively solid because of the presence of hard bone. Differences in sound are due largely to the amount of fluid in the tissue or body cavity, which can be an important indicator of normal or abnormal functions.
- Auscultation. Using a stethoscope, the physician will listen to the heartbeat and other sounds within the body. Normal functions and many abnormal conditions have characteristic sounds that can be identified through this process.
More specifically, the physician may assess the following:
- Vital signs
- General appearance
- Eyes, ears, nose, throat and mouth
- Neck, particularly the thyroid gland and cervical lymph nodes
- Respiratory, cardiovascular and gastrointestinal systems
- Breast examination for women and men
- Muscles, joints, bones and skin
- Neurological and psychiatric condition
- Genitals (including men's prostate gland and testicles and women's pelvic area, though many women instead have their pelvic exam when they see a gynecologist)
There is some question regarding the optimal schedule for physical examinations. In the past, most physicians recommended annual physical exams for all patients. Routine screening tests were also ordered at this time. Some medical groups, however, now recommend that the frequency of routine physical examinations be dependent on the person's age, medical history and other factors that might influence diseases. By targeting patient groups specifically, it may be more logical to include relatively costly screening tests in some populations and forgo tests in other populations. Patients are advised to consult their primary care physician about the timing of physical examinations and what the exams should include.
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